Mitotic Rate is Associated with Positive Lymph Nodes in Thin Melanomas.
Journal of the American Academy of Dermatology(2018)
Abstract
The American Joint Commission on Cancer will remove mitotic rate from its staging guidelines in 2018.Using a large nationally-representative cohort, we examined the association between mitotic rate and lymph node positivity among thin melanomas.149,273 thin melanomas in the National Cancer Database were examined for their association between high-risk features of mitotic rate, ulceration, and Breslow depth, with lymph node status.Among 17,204 thin melanomas with data on Breslow depth, ulceration, and mitotic rate who underwent a lymph node biopsy, there was a strong linear relationship between odds of having a positive lymph node and mitotic rate (R2 = 0.96, p <0.0001, β = 3.31). The odds of having a positive node increased by 19% with each 1-point increase in mitotic rate (Odds ratio 1.19, 95% confidence interval 1.17 - 1.21). Cases with negative nodes had a mean mitotic rate of 1.54 + 2.07 mitoses/mm2, compared to 3.30 + 3.54 mitoses/mm2 for those with positive nodes (p < 0.0001 LIMITATIONS: The data collected do not allow for survival analyses CONCLUSION: Mitotic rate was strongly associated with the odds of having a positive lymph node and should continue to be reported on pathology.
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Key words
clinical research,guidelines,melanoma,mitotic rate,skin cancer,staging
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